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Prediction model for respiratory-related mortality in microscopic polyangiitis with interstitial lung disease: multicentre REVEAL cohort study.
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 May 03; Vol. 63 (6), pp. 1607-1615. - Publication Year :
- 2024
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Abstract
- Objective: This study aimed to establish prediction models for respiratory-related mortality in microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using clinical characteristics.<br />Methods: We enrolled patients with MPA with ILD between May 2005 and June 2021 in a multicentre cohort of Japanese patients with MPA (REVEAL cohort). We evaluated the demographic, clinical, laboratory, radiological findings, treatments and the presence of honeycombing 1 cm above the diaphragm using chest high-resolution CT (HRCT) on admission. We explored the risk factors predictive of respiratory-related mortality.<br />Results: Of 115 patients, 26 cases died of respiratory-related diseases during a median follow-up of 3.8 years. Eighteen patients (69%) died due to respiratory infection, three (12%) had diffuse alveolar haemorrhage, and five (19%) had exacerbation of ILD. In univariate analysis, older age, lower percent forced vital capacity (%FVC), lower percent diffusing capacity of carbon monoxide (%DLCO), and the presence of honeycombing in the right lower lobe were identified as risk factors. Additionally, in multivariate analysis adjusted for age and treatment, %FVC, %DLCO and the presence of honeycombing in the right lower lobe were independently associated with respiratory-related mortality. We created prediction models based on the values of %FVC, %DLCO and presence of honeycombing on chest HRCT (termed "MPF model"). The 5-year respiratory-related death-free rate was significantly different between patients with MPA with ILD stratified by the number of risk factors based on the MPF model.<br />Conclusions: Our study indicates that the MPF model may help predict respiratory-related death in patients with MPA with ILD.<br /> (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Humans
Male
Female
Aged
Middle Aged
Risk Factors
Cohort Studies
Vital Capacity
Japan epidemiology
Tomography, X-Ray Computed
Prognosis
Lung Diseases, Interstitial mortality
Lung Diseases, Interstitial physiopathology
Lung Diseases, Interstitial diagnostic imaging
Lung Diseases, Interstitial complications
Microscopic Polyangiitis complications
Microscopic Polyangiitis mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 63
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 37632776
- Full Text :
- https://doi.org/10.1093/rheumatology/kead444